Presentation on theme: "Newham Primary Psychological Services"— Presentation transcript:
1Newham Primary Psychological Services Neelam DosanjhHead of ServiceMonton JienpetivateDeputy HeadNewham’s Model
2Newham Profile Population 308, 800 High transient population 4th most deprived borough in LondonDiversityYoung population - 60% aged between 25 and 4570% are from different ethnic backgrounds, 130 languagesEmployment- Approximately 10% are unemployed double London’s average, no change post 2012Second highest in benefit claims60% of ESA claimants report having mental health issuesHealth Inequalities
3Service ProfileExtended IAPT with specialist provision for LTC and MUS, Peri- Natal MH, Eating Disorders, TraumaStepped Care Model – 0 to step 4a7000 Referrals per yearApprox into treatmentTherapy choice is a priority but can’t always deliver due to capacity - CBT, DIT, IPT, Systemic, IntegrativeSub contract to Third sector for counselling, a service for DV and welfare and employment
4DriversMental ill-health is prevalent in the working age population and is associated with high economic and social costs to individuals and society at large.Improving the wellbeing of people with mental health problems and helping them find and sustained employment remains a challenge to health and employment services alike.Unemployment and being out of work are seen as key drivers behind mental ill-health (Pevalin and Goldberg, 2003; Paul and Moser, 2009). Employability and returning to work helps to improve mental wellbeing (Paul and Moser, 2009; McManus et al., 2012.
5Profile of Service Users accessing Employment Service Length of depression and anxiety – 2 to 5 yearsSocial isolation and exclusionPoor motivation and self esteem – extrinsically drivenLow educational attainmentWorkless-ness in the familyCo – morbidities – substance misuse, poverty, safeguarding issues, poor social stability (welfare), physical ill health
6Integrated Model Barriers: Integrated Provision: Cultural shift : To employment for people with mental health problems is the stigma and discrimination (Centre for Mental Health, 2013)Is the ‘benefit-trap’ when benefits create stronger incentives to remain in the system rather than return to work ( Lelliott et al., 2008)Integrated Provision:The integrated employment service within Newham IAPT offers opportunities to overcome these barriersCultural shift :Therapists to assist the engagementSUs – suspicious, disengagement
7Integrated Model - Benefits Provides social stability to better engage with the therapeutic processEase of access for Service UsersLearning , having a shared language and tailoring service provisionImproves the Service User’s overall experience of care, engagement, quality, retention in employment and provides a longitudinal approach to improved well being
8Integrated Model - Benefits Collaboration and close working ensures employment and wellbeing goals are aligned and realisticEmployment service has excellent links with national and local employers and employer support services such as Access to WorkThe in work support provided by the employment service ensures early intervention for Service Users who are in work, and need additional mental health support to successfully retain their job.
9Work of employment advisors Forming relationships with Service UsersAssessing literacy and skillsEmployment steps - identifying competenciesCoaching on motivation and confidence buildingJob searches – matching competenciesAssisting with CV writing and application formsPreparing for interviewsEmployer engagementLiaising with educational and welfare agencies
10Data for a year period- July 2013 to July 2014 Number of people referred for employment support517100%Number of people moving off sick pay and benefits21842%Total number moving from unemployment to paid work ( 15 self employment )408%Number moving from unemployment to part time or full time student9919%Number retaining full time work12424%Number retaining part time work367%
11IAPT Employment Initiative Newham IAPT and local partnershipLetwin pilot project: Newham IAPT engagement
12IAPT Employment Initiative: existing partnership Local initiatives between Newham IAPT and Work Programmes set up in 2012Initial meeting with all local main providersCDG and A4e signed up
13IAPT Employment Initiative: Existing partnership Planning and pre-referral stageEstablishing relationships with advisors and fostering engagementTraining provided by IAPTOngoing contact, consultation, follow-up and engagementPathway mapping and Referral and infrastructure configurationEvaluation: Joined by UCL Partners
14IAPT Employment Initiative: Existing partnership SuccessRelationshipCommitment from staff from both sidesSupport and accessibility of IAPT staff to advisorsAdvisors increased confidence in their role and engagement with customersChallengesLearning each other’s “language” and systemGovernance, information sharing and data sharingKeeping on the task, and maintaining enthusiasm
15Letwin Pilot Project: Aims “The purpose of the pilot is to test the impact on benefit off-flows of a client receiving support from the NHS (provided by IAPT). The focus will be Employment and Support Allowance (ESA) claimants in the Work Related Activity Group (WRAG) who report a common mental health condition that may impact on their ability to job search. These claimants will be engaged with the Work Programme.”
16Letwin Pilot Project: Scope “Advisers to address job search and employment and establish if progress may be restricted by a common Mental Health Condition – advisers are not expected (nor should attempt to) to diagnose mental health conditions, but to identify where it impacts on Job search activities and employment and refer those who consent to the support.”
17Letwin Pilot Project: Scope One thousand claimantsEight providers across the course of four months from September 14.The referrals will be voluntary and no sanctions can be applied for non-participation. Both existing claimants and new claimants of ESA.
18Letwin Pilot Project: Newham IAPT engagement Preparation stageBeing “introduced” to selected partners – Seetec and CDG (Shaw Trust)Process mapping, information sheets, data sharing, referral form and processWeekly conference call/ feedback with the pilot team
19Letwin Pilot Project: Newham IAPT engagement Local implementationActive engagement “at the top” - Three-way meeting – IAPT, Primes and the project teamNegotiating a model, establishing contact points and referral route with managementEstablishing and maintaining relationshipsInformation session with advisorsOne-to-one, team consultationMaintaining contactIn-house communication, configuring IAPTus, referral pathway, tracking and engaging booking and clinical staff
20Letwin Pilot Project: Newham IAPT engagement Two modelsA dedicated advisor as a link personMeeting with local manager and the advisor to clarify aim of the project, criteria and secure commitmentIndividual meeting with the advisor to help identify appropriate referralsRegular contactAll advisors make referralsA half-day information session, including “refreshers” session of previous training and referral routeEstablish referral handling, feedback and information sharingRegular contact via dedicated team leader and individually about outcomes of referrals
23Current status 53% made it through to assessment completion; 47% dropped out at booking and pre-assessment
24IAPT Employment Initiative: Letwin Pilot Project Learning pointsEngagement and relationship is the key.Commitment from the top is vital.Be adaptive and understand our partners’ organisation needs and pressure, e.g. avoid training at the end of the month, multiple sessions as needed to ensure enough advisors on the ground to keep the business open.Keep it simple. Advisors are busy and have a high caseload.If plan A does not work, have a plan B in place.Communication of outcomes – no-one would like to refer to a “black hole”.Ensure a robust and referral handling and tracking system.Engage and communicate with your own staff – clinical and booking team.